osteoporosis & bone health: an overview hazel buller development manager, n. ireland

Osteoporosis & Bone Health:

An Overview

Hazel Buller

Development Manager, N. Ireland

Topic areas• What is osteoporosis?

• Bone health / lifestyle changes / ‘Prevention’

• Diagnosis / ‘fracture risk assessment’

• Drug treatments

• Living with fragility fractures / broken bones

• New support initiatives from the Charity

Healthy bone Osteoporotic bone

© Tim Arnett, University College London (t.arnett@ucl.ac.uk)

Bone formation by osteoblast cells

Resting phase

Bone resorption by osteoclast cells

The Living Skeleton

• How much calcium do I need?• Do I need a supplement?• What about vitamin D?• What exercise can I do?• What can I do to stop falls?

Bone health / lifestyle changes to prevent fractures

• Charity publications: Exercise & osteoporosis; Healthy Living for strong bones Vibration therapy & osteoporosis Further food facts

Falls Risk Assessment Tool (FRAT) 2013

A simple tool like this can help establish whether a person needs further assessment and/or referral for investigation/intervention

• Bisphosphonate adverse effects – ONJ and atypical fractures

• Duration of treatment - ‘drug holidays’

• Calcium and vitamin D – risk of heart attack

• Vitamin D - supplements and testing

• Strontium ranelate - risk of blood clots; DRESS; heart attack (now only prescribed in special circumstances

• Denosumab – availability & adverse effects

• HRT and osteoporosis

• Generic drugs

Drug treatments

• When do I take my drug treatment?• How do I take my drug treatment?• Can I take other treatments at the same

time?• What about side effects?• How do I know it is working?• Is a generic drug the same

as a branded version?

Drug treatments

Information • Excellent, independent & free

• Unbiased & balanced

• Evidence based & up to date

Help • To make informed decisions

• To achieve a good quality of life

Support • Listening

• Caring • Trustworthy

NOS Helpline provides...

What questions are we asked?

• Landmark research project intended to promote a greater understanding of the lives of people with osteoporosis

• 3228 people completed a detailed questionnaire about the real impact of osteoporosis on their quality of life

• 52 were involved in either face to face interviews or keeping reflective diaries

• Many spoke movingly about the devastating consequences which osteoporosis and fragility fractures has had on their lives

‘Life with Osteoporosis’ Report

• Fracture Prevention Practitioner online training programme

New NOS Service Support Initiatives

New NOS Service Support Initiatives

• Fracture Liaison Service (FLS) Implementation Toolkit

• Fracture Liaison Service: Support Managers

• Peer Review• Clinical standards for FLS• Osteoporosis resources for primary care

clinicians –online resource supported by RCGP www. osteoporosis-resources.org.uk

What is your role?Has your patient had a fracture and is over50 years old?• Give exercise, nutritional and heath &

wellbeing advice, with referral as appropriate• Signpost them to our publications, NOS

helpline• Signpost them to Trust services and

information including PWT (Trust’s Promoting Wellbeing Team) e.g. smoking cessation clinics, strength and balance classes, falls clinics, falls directory

Do they need help with medication compliance?• Make use of the health

professional section of the NOS website. Share with your colleagues

• Signpost them to our publications

Identification of patients at risk of osteoporosis and who may need a DEXA? - role of the Trust FLS

How can we help you?

• Helpline is also for health professionals• Professional publications e.g.

Osteoporosis Review• E-newsletter and website news section• Professional membership of the Charity• UK Allied Health Professional Network• Osteoporosis resources website• Free patient publications and factsheets

(downloadable from our website)

Telephone: 0845 450 0230 or 01761 472721(Monday to Friday 9.00 – 17.00 hours)

 Email: nurses@nos.org.uk

(Replied to within 5 working days) Letter: National Osteoporosis Society,

Camerton, Bath BA2 0PJ (Replied to within 7 working days)

Discussion Forum: www.nos.org.uk ‘Ask the Nurses’ Forum (Open for 48 hours a week, replied to within 2 working days)

Contacting the helpline